This research will be conducted primarily at University of Cape Town and Groote Schuur Hospital (GSH) in Cape Town, South Africa, in collaboration with Sandra W. Jacobson, Ph.D., as an extension of NIH grant U01 AAO14790. The overall aim is to introduce two new magnetic resonance imaging (MRI) technologies- functional MRI and diffusion tensor imaging (DTI)-to South Africa and to apply them to evaluate children diagnosed with fetal alcohol syndrome (FAS) and possible FAS. Recent studies have documented an exceptionally high incidence of fetal alcohol syndrome (FAS) in the Cape Coloured (mixed ancestry) population. Dr. Jacobson's research in Cape Town and Detroit has identified specific aspects of arithmetic and executive function that may be core deficits of fetal alcohol spectrum disorder (FASD), which could be examined using MR technologies. To date FAS and FASD generally have not been examined using fMRI or DTI. GSH currently operates a 1.5T MR scanner, but no sites in South Africa have the capacity to conduct fMRI or DTI. Ernesta Meintjes, Ph.D., the foreign collaborator for this project, is a physicist trained in MR imaging. John C. Gore, Ph.D., is an internationally respected leader in the use of fMRI to examine information processing in children. The specific aims are to (1) train Dr. Meintjes to administer fMRI and DTI in Dr. Gore's laboratory at Vanderbilt University; (2) purchase and install the necessary software and hardware needed to administer these methodologies at GSH and train the radiographers to become proficient in their use; and (3) conduct a pilot study with 15 FAS, 15 possible FAS, and 15 matched control children to examine differences in brain morphology, functional activation of neural networks, and the integrity of white matter tracts. The cognitive tasks to be used in the fMRI assessment and neuropsychological tests to be performed outside the scanner have been selected to improve our understanding of the core deficits of FASD. The information to be generated has the potential to improve fetal alcohol diagnosis, facilitate earlier identification of affected children, and provide the basis to design earlier, more targeted interventions.